This appeared last week:
2021 Apr 16;9(1):19.
doi: 10.1007/s13755-021-00148-6. eCollection 2021 Dec.
Physicians' and pharmacists' use of My Health Record in the emergency department: results from a mixed-methods study
Alexandra K Mullins 1 , Heather Morris 1 , Cate Bailey 1 , Michael Ben-Meir 1 2 3 , David Rankin 2 , Mariam Mousa 1 , Helen Skouteris 1 4
Affiliations
- PMID: 33898021
- PMCID: PMC8051833
- DOI: 10.1007/s13755-021-00148-6
Abstract
Purpose: This study aimed to explore pharmacists' and physicians' perceptions of use, barriers to use and the healthcare outcomes associated with use of Australia's national personally controlled electronic health record-known as My Health Record-in the emergency department.
Methods: A mixed methods approach was deployed, including surveys and individual semi-structured interviews. All physicians and pharmacists who work in the emergency department at Cabrini Health (a non-for-profit healthcare provider in Victoria, Australia) were invited to participate. Due to the timing of elective blocks, physician trainees were excluded from interviews.
Results: A total of 40 emergency medicine clinicians responded to the survey. Over 50% (n = 22) of all respondents had used My Health Record in the emergency department at least once. A total of 18 clinicians participated in the semi-structured interviews, which led to the identification of three themes with multiple sub-themes regarding My Health Record: (1) benefits; (2) effectiveness; and; (3) barriers.
Conclusion: Participants reported My Health Record use in the emergency department delivers efficiencies for clinicians and has a heightened utility for complex patients, consistent with previous research conducted outside of the Australian setting. Barriers to use were revealed: outdated content, a lack of trust, a low perception of value, no patient record and multiple medical record systems. The participants in this study highlighted that training and awareness raising is needed in order to improve My Health Record use in the emergency department, a need stressed by physician's. Further observational research is required to explores meaningful MHR use at scale.
Keywords: Barriers; Efficiencies; Electronic health record; Emergency department; My health record; Patient outcomes.
Here is the link:
https://pubmed.ncbi.nlm.nih.gov/33898021/
Happily the full text of the article is available as a .pdf here:
https://link.springer.com/content/pdf/10.1007/s13755-021-00148-6.pdf
The Abstract is a good summary of the paper which is really hampered by the relatively number of clinicians who were using the system and the low number of frequent users. There seemed to be only a few occasions reported when the #myHR was seen as valuable and making a difference.
Clearly, if present, the pharmacists found the #myHR useful to confirm a patient’s medication but absent useful data was a problem for both types of users.
All in all, an interesting effort in the absence of any properly funded research from the ADHA which we have been promised for years now!
David.
11 comments:
First of all read the book that Andrew pointed at:
Not Even Trying The Corruption of Real Science by Bruce Charlton
Then have a look at some the responses in the light of the government's claim.
Claim: Your medical history will be available to other health professionals. The ED would seem to be a place where you history could be useful.
Response:
In the section "Use MHR to find:"
Only 1 physician out of 22 who bothered to use MHR looked for Medical History.
Of the other questions, many asked about information that can or could be obtained elsewhere.
Then there's this:
What encourages you to use MHR:
I feel well trained to access MHR
That doesn't make sense. The reverse might be true - i.e. a barrier is that they haven't been trained.
This is relevant to the eScript issue that was discussed yesterday:
I’m always double-checking with the patients because sometimes the way they’re taking [their medication] is different [from what is presented in MHR] [Pharmacist 05, high MHR user].
This looks like confusion. What should a pharmacist believe
And finally, what role do pharmacist play in the ED?
All pretty hum-ho. No doubt the ADHA will cherry-pick the data, which already looks as though it presents MYHR in the best possible light anyway.
Back to Not Even Trying.
There is always a Frank and a propeller head consultant ready to help them along and nod excessively, providing a false sense of wisdom. People can’t learn if those around them keep commenting on how well they look in a birthday suit.
The government wants to go digital but doesn't know what that means, having hollowed out their real world expertise in science, engineering and technology. It's all been outsourced because they are not "key skills"
They do have a few people who believe they know what it means having read about it in all the best vendor brochures. It's just a pity they don't understand science, engineering and technology.
The ADHA/NEHTA believe they have been doing digital for ages and claim to have a track record. Consultants believe they understand digital, but it’s difficult to believe that anyone can consult when nobody is actually an expert in digital (apart from in their own minds)
The whole thing is a belief system that feeds back on itself. A bit like a religious cult
Come to think of it, digital health has a lot in common with conspiracy theorists and intelligent design. Lots of belief but little to no evidence of reality.
I do not NEHTA ever considered itself to be about digital. That came shortly after the My Health Record rebranding, and there was a drive to change the language. And let's be real here,m the PCEHR was a DOHA thing. When I worked on PCEHR at NEHTA, the two were very much separate beasts. NEHTA got stained because PCEHR was a bully client and sucked the life out of all around it. The decline that started in 2012 in NEHTA's outputs was directly related to PCEHR. I was there when they were forced to reverse engineer Accenture solution and publish them as specification. That pretty much triggered me to leave.
Sounds like a mess that is still reverberating in the offices of ADHA.
@2:24PM ".... the My Health Record [MHR] rebranding ....". Oh therein lies a long saga of gamesmanship and bureaucratic stupidity and incompetence. They got themselves into a huge costly mess when attempting to Trademark My Health Record in 2014/2015, as registration was blocked by My Personal Health Record [MyPHR] which had already been registered and protected since 2006.
On reflection, after the monumental mess that has transpired since 2015 I often wonder whether I may have unintentionally done the Australian community a disservice by yielding to the enormous constant pressure and intimidation the government applied in its futile and unreasonable attempts to have the MyPHR trademark deregistered!
Perhaps I shouldn't have accepted the government's very generous offer to assign the IP rights to MyPHR to them, thus paving the way forward for MHR to be registered. The rationale for doing so was that big bullies with unfathomable firepower, truckloads of incompetence and no practical understanding of health IT were not worth the time of day. Best to take their money and leave well alone.
It's a pity the government hasn't branded and protected "My Health Record".
https://www.myhealthrecord.com/Portal/SSO
There's no indication at all on the site that it is not the Australian version. It's the only thing you can get to (apart from login help) without a log-in.
Maybe it's an indication just how much the ADHA values its brand.
It's almost they are happy that someone is telling the world about all the features that are not in the Oz version.
This is often done on Twitter using #myhealthrecord", which Australians also use.
You have to do a bit of digging to find out what the vendor does but it's all here:
https://www.greenwayhealth.com/solutions
Their My Health Record looks like an implementation of Greenway Health’s electronic health record system which is independent of any specific healthcare practice.
May 07, 2021 11:06 AM - a bold claim - I take it the pubs are open in Sydney again
@12:51 PM Greenway Health, LLC is a privately-owned company currently based in Florida.
By the Australian government registering the My Health Record trademark with IP Australia it is effectively branded and protected and precludes infringement by third parties from using the mark in Australia without the government's permission (ie. being licensed to use it). This effectively brands and protects against unauthorized use of the My Health Record mark anywhere for any reason in the Australian health market Australia.
The Government might be taking it seriously Bernard, it might explain why all the latest appointments have more in common with injury lawyers than paramedics.
@anon 1:25pm
In which case they are taking the wrong thing seriously - their own protection.
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